Yang Youngsoon, Huh Kyoon, Kwak Yong Tae
Department of Neurology, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan 31151, Republic of Korea.
Department of Neurology, Hyoja Geriatric Hospital, Yongin 17089, Republic of Korea.
J Pers Med. 2025 Feb 25;15(3):82. doi: 10.3390/jpm15030082.
Hospitalization for severe neuropsychiatric symptoms in Alzheimer's disease (AD) presents challenges, often requiring environments that ensure safety while addressing therapeutic needs. Traditional closed wards, originally designed for psychiatric conditions like schizophrenia, may not fully address the unique needs of AD patients. This study evaluates the effectiveness of a Specialized Dementia Ward (SDW) tailored for AD patients compared to a General Ward (GW). A retrospective study compared 51 AD patients in an SDW (February 2018-January 2019) and 40 AD patients in a GW (December 2017-January 2018). Patients met NINCDS-ADRDA criteria, with a Clinical Dementia Rating (CDR) ≤ 2 and a Korean Mini-Mental State Examination (K-MMSE) ≤ 20. Clinical assessments at admission and four weeks included K-MMSE, Resident Assessment Instrument Minimum Data Set Version 2.0 (RAI-MDS), and Neuropsychiatric Inventory Questionnaire (NPI-Q). Psychotropic medication use, length of stay, and discharge destination were also analyzed. No statistically significant differences emerged between SDW and GW groups regarding baseline demographics, cognitive function, ADL, or neuropsychiatric symptoms. At four weeks, both groups exhibited trends toward improved K-MMSE, RAI-MDS, and NPI-Q scores and reduced psychotropic usage, but these did not reach statistical significance. Although mean length of stay was shorter for SDW patients (3.2 vs. 4.9 months; = 0.078), the difference was not significant. Notably, a significantly higher proportion of SDW patients were discharged home (58.8% vs. 37.5%; = 0.049). Although clinical outcomes were comparable, the SDW demonstrated advantages in facilitating discharge to home, suggesting that tailored ward environments may better support AD patients. These findings underscore the importance of therapeutic environments in dementia care and highlight the need for further research on specialized dementia ward designs to improve outcomes and patient satisfaction.
阿尔茨海默病（AD）患者因严重神经精神症状住院面临诸多挑战，通常需要能确保安全且满足治疗需求的环境。传统的封闭式病房最初是为精神分裂症等精神疾病设计的，可能无法完全满足AD患者的独特需求。本研究评估了专为AD患者量身定制的专科痴呆病房（SDW）与普通病房（GW）相比的有效性。一项回顾性研究比较了SDW中的51例AD患者（2018年2月至2019年1月）和GW中的40例AD患者（2017年12月至2018年1月）。患者符合NINCDS - ADRDA标准，临床痴呆评定量表（CDR）≤2且韩国简易精神状态检查表（K - MMSE）≤20。入院时及四周后的临床评估包括K - MMSE、居民评估仪器最小数据集第2.0版（RAI - MDS）和神经精神科问卷（NPI - Q）。还分析了精神药物的使用情况、住院时间和出院去向。SDW组和GW组在基线人口统计学、认知功能、日常生活活动能力或神经精神症状方面未出现统计学上的显著差异。四周时，两组的K - MMSE、RAI - MDS和NPI - Q评分均有改善趋势，精神药物使用减少，但未达到统计学显著性。虽然SDW患者的平均住院时间较短（3.2个月对4.9个月；P = 0.078），但差异不显著。值得注意的是，SDW患者出院回家的比例显著更高（58.8%对37.5%；P = 0.049）。虽然临床结果相当，但SDW在促进患者出院回家方面显示出优势，表明量身定制的病房环境可能更好地支持AD患者。这些发现强调了治疗环境在痴呆护理中的重要性，并突出了对专科痴呆病房设计进行进一步研究以改善治疗效果和患者满意度的必要性。
